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Development of generic core competences of health professionals in rheumatology: a systematic literature review informing the 2019 EULAR recommendations
  1. George E Fragoulis1,
  2. Lisa Edelaar2,3,
  3. Theodora P M Vliet Vlieland2,
  4. Annamaria Iagnocco4,
  5. Valentin Sebastian Schäfer5,
  6. Catherine Haines6,7,
  7. Jan Schoones8 and
  8. Elena Nikiphorou9,10
  9. on behalf of the EULAR Task Force
    1. 1Institute of Infection, Immunity and Inflammation, University of Glasgow School of Medicine, Glasgow, UK
    2. 2Department of Orthopaedics, Rehabilitation and Physical Therapy, J11, Leiden University Medical Center, Leiden, The Netherlands
    3. 3Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
    4. 4Scienze Cliniche e Biologiche, Università degli Studi di Torino, Rome, Italy
    5. 5Medical Clinic III, Department of Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
    6. 6EULAR, Zurich, Switzerland
    7. 7Department of Clinical Education, King's College London, London, UK
    8. 8Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
    9. 9Rheumatology Research, Academic Department of Rheumatology, King's College London, London, UK
    10. 10Applied Health Research, University College London, London, UK
    1. Correspondence to Dr Elena Nikiphorou; enikiphorou{at}


    Objective To identify generic competences on the desired knowledge, skills and of health professionals in rheumatology (HPRs) to inform the respective EULAR recommendations.

    Methods A systematic literature review was performed on the generic core competences (defined as knowledge, skills or attitudes) of HPRs (nurses, physical therapists (PTs) or occupational therapists (OTs)). Literature was obtained from electronic databases, published EULAR recommendations and via personal communication with representatives of national rheumatology societies and experts in the field. Qualitative, quantitative and mixed methods studies were included, and their methodological quality was scored using appropriate instruments.

    Results From 766 references reviewed, 79 fulfilled the inclusion criteria. Twenty studies addressed competences of multiple HPRs: 15 were of qualitative design, 1 quantitative, 1 mixed-methods, 2 systematic reviews and 1 opinion paper. The methodological quality of most studies was medium to high. Five studies concerned the development of a comprehensive set of competences. Key competences included: basic knowledge of rheumatic diseases, holistic approach to patient management, effective communication with colleagues and patients and provision of education to patients. The proposed competences were confirmed in studies focusing on one or more specific competences, on a rheumatic disease or on a specific profession (nurses, PTs or OTs).

    Conclusion Generic competences were identified for HPRs. Data were mostly derived from qualitative studies. All identified studies varied and were at national level, highlighting the need for the harmonisation of HPR competences across Europe. These findings underpin the development of EULAR recommendations for the core competences of HPRs.

    • physcial therapy
    • occupational therapy
    • nursing

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    • GEF and LE are joint first authors.

    • Twitter @ElenaNikiUK

    • Collaborators EULAR Task Force for the Development of generic core competences of Health Professionals in Rheumatology. Apart from the authors of this manuscript, the Task Force members were: Margôt Bakkers, (People with Arthritis and Rheumatism) PARE representative, The Netherlands; Lurdes Barbosa, Nurse, Serviço de Reumatologia (Hospital Dia Reumatologia - 6º Piso), Hospital Garcia de Orta, EPE, Almada, Portugal; Professor Nada Cikes, Rheumatologist, UEMS European Board of Rheumatology, University of Zagreb School of Medicine, Croatia; Dr Mwidimi Ndosi, Nurse, Epidemiologist, University of the West of England, Bristol, UK; Jette Primdahl, Nurse, Associate Professor at the University of Southern Denmark, King Christian X's Reuma Hospital and Hospital of South Jutland (ESNO), Denmark; Dr Yeliz Prior, Occupational Therapist, Epidemiologist, University of Salford, Salford Mid Cheshire NHS Trust, UK; Polina Pchelnikova, PARE representative, Russia; Valentin Ritschl, Occupational Therapist, data analyst, Medical University of Vienna, Austria; Hana Smucrova, Occupational Therapist, Institute of Rheumatology, Prague, Czech Republic; Inger Storrønning, Physical Therapist, University of Oslo, Diakonhjemmet Sykehus, Norway; Professor Marco Testa, Physical therapist, University of Genova Department of Neuroscience, Rehabilitation and Ophthalmology, Genetics, Maternal and Child Health Campus of Savona, Italy; Dieter Wiek, PARE representative, Germany.

    • Contributors Study design: TPMVV, EN, GEF and LE. Performed the systematic literature review: JS, LE, GEF and VSS (supervised by TPMVV and EN). Quality assessment and methodology: EN, TPMVV, GEF, LE and VSS. Manuscript drafting: GEF, LE and JS. revising manuscript and supervision: EN, CH and TPMVV.

    • Funding The task force would like to thank EULAR for financial support of this work.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.

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